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General NPI Number Information
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NPI Number | 1023438488
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Entity Type | Organization
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Legal Business Name | TIMOTHY ROBERT MILLER, M.D., INC.
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 2 JOURNEY STE 208
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3332
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Country | US
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Telephone | 949-973-5175
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Fax | 949-215-5428
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Provider Business Mailing Address
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Address Line | 2 JOURNEY STE 208
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3332
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Country | US
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Telephone | 949-973-5175
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Fax | 949-215-5428
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. TIMOTHY ROBERT MILLER
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Credential | M.D.
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Telephone | 949-973-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A90958
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License Number State | CA
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